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To the best of our knowledge, no randomised controlled trial evidence exists to answer the question of early vitrectomy surgery for the treatment of endophthalmitis following any eye surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicentre, national prospective randomized controlled clinical (RCT) trial aimed to assess the feasibility of randomizing patients to an early vitrectomy (Arm-A) intervention within 48-96\u2009hours compared to current standard patient care of repeated, immediate intravitreal antibiotic injection (Arm-B) and delayed vitrectomy. There was no blinding or masking conducted in the trial. The key inclusion criteria were: over 18 years of age; confirmed diagnosis of POE at any time-point following an ocular surgery, procedure, or injection; symptomatic visual loss attributable to POE; best corrected visual acuity (VA) worse than 35 ETDRS letters, including counting fingers, hand motions and perception of light vision. The key exclusion criteria were: known adverse reaction to intravitreal antibiotics (amikacin\/vancomyin\/cephalosporins); optic atrophy in study eye; corneal oedema or haze that would prevent visualisation of fundus to perform vitrectomy surgery. The primary outcome measure was, the feasibility and acceptability of carrying out a RCT of early surgical treatment compared to standard treatment for POE. ClinicalTrials.gov NCT04522661 (13\/08\/2020).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Here we show that the study is feasible and meets the primary endpoint whereby 63 participants are randomized at 79% recruitment rate. Median change in VA (IQR) as per-protocol from baseline-to-week 24 was 40 (28-70) letters in Arm-A (n\u2009=\u200924) versus 13 (0-66) letters in Arm-B (n\u2009=\u200925); corresponding to a between-group difference of 24 letters, adjusted for baseline, in favour of early vitrectomy (p\u2009=\u20090.139). Higher rate of non-serious adverse events observed in Arm-B (68%) compared to Arm-A (47%), with higher incidence of retinal detachment 8 cases (24%) in Arm-B versus 2 cases in Arm-A (6.7%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The EVIAN trial meets the primary endpoint demonstrating feasibility in conducting a trial to randomize the target population at multiple eye centres. Although not statistically significant, the effect on VA change indicates a potential meaningful benefit of vitrectomy compared to standard of care treatment, which can now be tested in a definitive phase 3 clinical trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s43856-026-01664-w","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T14:36:22Z","timestamp":1784212582000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early vitrectomy and intravitreal antibiotics for post-operative exogenous endophthalmitis (EVIAN): a randomised control trial of feasibility"],"prefix":"10.1038","volume":"6","author":[{"given":"Mahiul 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